<!--[pnpageaddvar name="javascript" value="http://ajax.googleapis.com/ajax/libs/jquery/1.4/jquery.min.js"]-->
<!--[pnpageaddvar name="javascript" value="modules/SpaService/pnjavascript/datepicker/development-bundle/ui/jquery.ui.datepicker.js"]-->
<!--[pnpageaddvar name="javascript" value="modules/SpaService/pnjavascript/datepicker/development-bundle/ui/jquery.ui.core.js"]-->
<!--[pnpageaddvar name="javascript" value="modules/SpaService/pnjavascript/datepicker/development-bundle/ui/jquery.ui.widget.js"]-->

<!--[pnpageaddvar name="stylesheet" value="modules/SpaService/pnjavascript/datepicker/development-bundle/themes/base/jquery.ui.all.css"]-->

<script type="text/javascript">
	$(function() {
      $("#date_picker").datepicker({
        changeMonth: true,
        changeYear: true,
		yearRange: '1900:<!--[$smarty.now|date_format:"%Y"]-->',
		altFormat: 'yy-mm-dd',
		dateFormat: 'yy-mm-dd',
		appendText: '(yyyy-mm-dd)'
    });
  });
</script>

<div id="stylized-form">
	<h2><!--[gt text='Category Form']--></h2>
	<form method="post" action="<!--[pnmodurl modname=spaservice type=adminform func=submit ctrl=spaemployee]-->">
	<input name="form[id]" type="hidden" size="40" value="<!--[$smarty.get.id]-->" />
	
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='First Name']-->
		</label>
		<input name="form[firstName]" type="text" size="40" value="<!--[$form.firstName]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Last Name']-->
		</label>
		<input name="form[lastName]" type="text" size="40" value="<!--[$form.lastName]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Nickname']-->
		</label>
		<input name="form[nickname]" type="text" size="40" value="<!--[$form.nickname]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Gender']-->
		</label>
		<input type="radio" name="form[gender]" value="male"> Male <input type="radio" name="form[gender]" value="female"> Female 
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Ability']-->
		</label>
		<!--[checker_object_array_ex modname=SpaService class=spacategory name=form[spamenu] selectedValue=$form.spamenu displayField=title]-->
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Birthday']-->
		</label>
		<INPUT TYPE="text" NAME="form[birthday]" value="<!--[$form.birthday]-->" ROWS="10" COLS="40" id="date_picker" >
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Blood Group']-->
		</label>
		<input type="radio" name="form[bloodGroup]" value="A"> A <input type="radio" name="form[bloodGroup]" value="AB"> AB <input type="radio" name="form[bloodGroup]" value="B"> B <input type="radio" name="form[bloodGroup]" value="O"> O 
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Telephone']-->
		</label>
		<input name="form[telephone]" type="text" size="40" value="<!--[$form.telephone]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Mobile Phone']-->
		</label>
		<input name="form[mobilePhone]" type="text" size="40" value="<!--[$form.mobilePhone]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='E-Mail']-->
		</label>
		<input name="form[email]" type="text" size="40" value="<!--[$form.email]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Address']-->
		</label>
		<input name="form[address]" type="text" size="40" value="<!--[$form.address]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='City']-->
		</label>
		<input name="form[city]" type="text" size="40" value="<!--[$form.city]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='State']-->
		</label>
		<input name="form[state]" type="text" size="40" value="<!--[$form.state]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Country']-->
		</label>
		<input name="form[country]" type="text" size="40" value="<!--[$form.country]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Post']-->
		</label>
		<input name="form[post]" type="text" size="40" value="<!--[$form.post]-->" />
	</div>
	<div class="wrapper-block">
		<label for="user">
			<!--[gt text='Special Detail']-->
		</label>
		<textarea name="form[specialDetail]" rows="2" cols="20" /><!--[$form.specialDetail]--></textarea>
	</div>
	<input type="submit" value="submit">
	</form>
</div>